Suppression of Angioplasty-Related Inflammation by Pre-Procedural Treatment with Trimetazidine

Suppression of Angioplasty-Related Inflammation by
Pre-Procedural Treatment with Trimetazidine

FILIZ KURALAY, EMEL ALTEKIN, AYTEN SAYIN YAZLAR,¹ BANU ONVURAL and OZHAN GOLDELI¹

Departments of Biochemistry, and ¹Cardiology, Dokuz Eylul University, School of Medicine, Izmir, Turkey

Percutaneoustransluminal coronary angioplasty (PTCA) has been recognized as a reliable treatment procedure for acute reversible ischemia and reperfusion. Ischemic reperfusion cycle in PTCA leads to the systemic inflammation and extensive tissue injury by the production of reactive oxygen species including nitric oxide (NO) radicals. In patients with coronary artery disease, undergoing PTCA, the effects of trimetazidine (TMZ), a piperazine-derivative anti-anginal drug, were studied on several indirect markers of systemic inflammatory response: tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and NO products (nitrite and nitrate). Patients (n = 11 each group) were untreated or pre-treated with TMZ (20 mg per orally three times a day), begun three days prior to PTCA, and marker levels were measured before the start of TMZ therapy (baseline), just before PTCA (0 hr), and 4, 24, and 48 hrs after PTCA. The baseline levels of markers were not significantly different between the untreated and pre-treated patients. In contrast, all parameters were lower in the TMZ-treated group than those in the matched control group in the pre- and post-angioplasty periods. Interestingly, in the TMZ group, CRP and nitrite levels were significantly lower than in the control group at each time point of the pre- and post-angioplasty periods, but the TNF-α levels were significantly decreased only in the post-angioplasty period. Pre-procedural treatment with oral TMZ for three days significantly suppressed the elevation of inflammatory markers before and shortly after PTCA. We suggest the usefulness of TMZ in preventing inflammatory cardiovascular events after PTCA.

keywords —— ine; percutaneous transluminal coronary angioplasty; C-reactive protein; nitric oxide; tumor necrosis factor-α.

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Tohoku J. Exp. Med., 2006, 208, 203-212

Received June 1, 2005; revision accepted for publication December 23, 2005. Correspondence: Filiz Kuralay, Department of Biochemistry, Dokuz Eylul University, School of Medicine, Balçova, Izmir 35340, Turkey

e-mail:filiz.kuralay@deu.edu.tr